Borderline Personality Disorder (BPD):

History:

Laila had a history of unstable relationships, due to issues of anger, jealousy, trust concerns and emotional neediness. She felt very insecure in her bonds with people close to her, and this insecurity was further amplified in romantic relationships.

When she came in, Laila was in a relationship of two and a half years with her girlfriend, Terri*. They experienced strain due to Laila’s “episodes,” but Terri was supportive and later involved in Laila’s treatment, in a psychoeducational session.

Laila’s family was loving but highly critical and competitive. Her parents were successful professionals, who frequently had limited time resources for Laila and her siblings. Further to this, Laila’s eldest sister was held as a “perfect standard” for her beauty and academic achievements, which put pressure on Laila. She was a highly sensitive child, who often felt lonely. In her teenage years she developed bulimia, though was never formally diagnosed. In her twenties, she alternated between episodes of binging and purging, promiscuity, drinking and suicidality. As she approached her thirties her relationships remained unstable, but her self-harming, high-risk behaviours became rarer.

Treatment began with the identification of non-nurturing elements in her family of origin experience and linking these to limiting beliefs held by Laila. From there, Laila was assisted in understanding the dysfunctional needs’ behavioural, emotional and cognitive consequences. After this stage, Laila had 21 sessions of bi-lateral stimulation and exposure therapy reprocessing. Each session had a scaled measure and Laila’s episodes of negative behaviours grew farther and farther apart, and her negative skew began to move.

Results:

Laila’s episodes of heightened emotionality in her relationship stopped completely

Laila exhibited no drinking, self-harming, suicidal or binging and purging behaviours upon completion

Laila’s body image improved vastly, but she still had some feelings of discomfort with her body

Her friendships and romantic relationships stabilized, and Laila was able to express needs without feeling a threat of abandonment

Laila discontinued contact with her older sister, without feeling guilty, due to the toxic nature of their relationship

Laila’s increased self-confidence entered the work realm and allowed her to apply for a promotion, which she received

Discussion:

In reprocessing the central limiting beliefs involved in Borderline Personality Disorder(BPD), a more positive sense of self could be established, which vastly reduced the trigger potential and potency Laila experienced. “I am shameful” and “I am unwanted” are two central core beliefs experienced by individuals with BPD. These create the classic push-pull dynamics so central in their relationships.

Once reprocessed, the individual is better able to feel secure in their attachments, leading to more stable self-images, as well, because we often know ourselves in the context which we know others. The removal of Laila’s largest limiting beliefs allowed her to create positive beliefs about self, which removed the effects of cognitive dissonance toward the negative. Laila could, at the conclusion of therapy, benefit with the refinement of minor triggers, but she is more than functional and content.

Case study 3: Borderline Personality Disorder Treatment

Presenting Concern:

Laila* was a young lady who had been diagnosed with Borderline Personality Disorder (BPD) by a local psychiatrist over three years ago. She was seeking assistance for the treatment of these symptoms, especially the emotional dysregulation, self-harm and disruption to her relationships.

* All names and all identifying information have been altered. Case studies are posted with client permission.

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